Department of Pathology, Pusan Paik Hospital, Inje University, Busan, Korea.
J Korean Med Sci. 2010 Nov;25(11):1683-7. doi: 10.3346/jkms.2010.25.11.1683. Epub 2010 Oct 26.
A 50-yr-old male presented a thyroid mass with dysphasia and hoarseness. He underwent total thyroidectomy and neck node dissection. Pathologically, the tumor had two distinct tumor components with intermingled areas: follicular variant of papillary carcinoma and mucoepidermoid carcinoma. Mucoepidermoid carcinoma composed of columnar cells, mucocytes, and squamoid cells showing solid and cystic lesion. Several small cysts lined by benign ciliated columnar epithelia suggesting that this tumor had originated from solid cell nest were seen around the tumor. By immunohistochemistry, columnar cells and squamoid cells in mucoepidermoid carcinoma were positive for cytokeratin but negative for thyroglobulin, TTF-1 and calcitonin. Positivity of p63 was seen in squamoid cells and basal cells of cysts. Some mucocytes are CEA positive. Tumor cells of papillary carcinoma are positive for TTF-1, thyroglobulin but negative for CEA, calcitonin and p63.
一位 50 岁男性因甲状腺肿块伴吞咽困难和声音嘶哑就诊。他接受了甲状腺全切除术和颈部淋巴结清扫术。病理上，肿瘤有两个截然不同的肿瘤成分，并有混合区域：滤泡型乳头状癌和黏液表皮样癌。黏液表皮样癌由柱状细胞、黏液细胞和鳞状细胞组成，表现为实性和囊性病变。肿瘤周围可见几个由良性纤毛柱状上皮衬里的小囊肿，提示该肿瘤起源于实性细胞巢。免疫组化染色显示，黏液表皮样癌中的柱状细胞和鳞状细胞对细胞角蛋白呈阳性，但对甲状腺球蛋白、TTF-1 和降钙素呈阴性。鳞状细胞和囊肿的基底细胞对 p63 呈阳性。一些黏液细胞 CEA 阳性。乳头状癌的肿瘤细胞对 TTF-1、甲状腺球蛋白呈阳性，但对 CEA、降钙素和 p63 呈阴性。
